Medical records compiled by doctors caring for prisoners at the U.S. detention camp at Guantanamo Bay are being tapped to design more effective interrogation techniques, says an explosive new report.

Doctors, nurses and medics caring for the approximately 600 prisoners at the U.S. naval base in Cuba are required to provide health information to military and CIA interrogators, according to the report in the respected New England Journal of Medicine.

"Since late 2003, psychiatrists and psychologists (at Guantanamo) have been part of a strategy that employs extreme stress, combined with behavior-shaping rewards, to extract actionable intelligence from resistant captives," it states.

Such tactics are considered torture by many authorities, the authors note.

Medical personnel belonging to the U.S. military's Southern Command have also been told to volunteer to interrogators information they believe may be valuable, the report adds.

The report was published ahead of schedule last night on the journal's website "because of current public interest in this topic," the journal says.

The report's authors — Dr. Gregg Bloche, a physician who is also a law professor at Georgetown University in Washington, and Jonathan Marks, a London lawyer who is currently a fellow in bioethics at Georgetown's law center— say that while Guantanamo veterans are ordered not to discuss what goes on there, making it difficult to know how, exactly, military intelligence personnel have used medical information for interrogation, they've been able to assemble part of the picture.

They suggest that interrogators at the camp, set up in 2001 to detain prisoners captured in Afghanistan and later Iraq, have had access to prisoners' medical records since early 2003.That contradicts Pentagon statements that there is a separation between intelligence-gathering and patient care.

William Winkenwerder, U.S. assistant secretary of defense for health affairs, said in a memo made public in May that Guantanamo prisoners' medical records are considered private — as are American citizens'.

However, "this claim, our inquiry has determined, is sharply at odds with orders given to military medical personnel and with actual practice at Guantanamo," the authors write. Using medical records to devise interrogation protocols crosses an ethical line, said Peter Singer, director of the University of Toronto's Joint Center for Bioethics.

"The goal for the physician is to care for the sick, not to aid an interrogation," he said. "Patients are patients and prisoners are prisoners and mixing those two things on the part of physicians who work in prisons is actually quite dangerous. Physicians are there for the benefit of patients and if they are seen to be there for some other purpose, it really blurs what they're doing."An Amnesty International Canada spokesman said the report gives serious pause to anyone who is following what happens at Guantanamo.

"This reinforces the necessity for a full, independent commission of inquiry into the detentions. What is going on and what rules are being violated," John Tackaberry said from Ottawa. "The American government needs to accept its responsibility to expose what is actually happening and show the world they are following standards that are acceptable in terms of international law," he said.

According to the authors, a previously unreported U.S. Southern Command policy statement dated Aug. 6, 2002, instructs health-care providers that communications from "enemy persons under U.S. control" at Guantanamo "are not confidential and are not subject to the assertion of privileges" by detainees.

That policy memorandum also tells medical personnel they should "convey any information concerning ... the accomplishment of a military or national security mission ... obtained from detainees in the course of treatment to non-medical military or other U.S. personnel who have an apparent need to know the information," the authors found. The only limit on the policy is that caregivers cannot themselves act as interrogators, the authors say. But since the policy calls on caregivers to hand over information they think might be valuable, they are, in effect, part of Guantanamo's surveillance network and "dissolving the Pentagon's purported separation between intelligence gathering and patient care," they write.

"An internal, May 24, 2005, memo from the Army Medical Command, offering guidance to caregivers responsible for detainees, refers to the `interpretation of relevant excerpts from medical records' for the purpose of `assistance with the interrogation process.'"The authors obtained the memo from a military source.

The article states that at Guantanamo, the "fear-and-anxiety" approach to interrogation was often favored.

"The cruel and degrading measures taken by some, in violation of international human rights law and the laws of war, have become a matter of national shame," Bloche and Marks observe.

"The global political fallout from such abuse may pose more of a threat to U.S. security than any secrets still closely held by shackled internees at Guantanamo Bay," they add.... .

On Tuesday, the Bush administration rejected a proposal to create an independent commission to investigate abuses of detainees at Guantanamo Bay. White House spokesperson Scott McClellan said the Pentagon has already launched 10 major investigations into allegations of abuse and the system was working well.

Mulugeta Abai, executive director of the Canadian Center for Victims of Torture in Toronto, wasn't surprised by the journal report. "This is practiced globally," he said. "This is very frustrating. A superpower that is considered a leader in many ways is losing its moral authority now, completely."

The New England Journal of Medicine is the second respected journal to criticize U.S. interrogation techniques.

The British medical journal The Lancet reported in August, 2004, that U.S. military doctors violated medical ethics as part of the interrogation regime at Iraq's Abu Ghraib prison....